Insurance Market Reform

The Internal Revenue Services (IRS) released proposed rules explaining the ACA’s shared responsibility provision and the process for determining eligibility for and granting certificates of exemption from the shared provision.

This proposed rule covers topics including the federal risk adjustment model, reinsurance parameters, cost-sharing reduction payment methodology, and user fees for insurers offering QHPs in federal exchanges.

This document proposes amendments to regulations, consistent with the Affordable Care Act, regarding nondiscriminatory wellness programs in group health coverage.

This proposed rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value, and it proposes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and an amendment which provides an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

This proposed rule, released by the Deparment of Health and Human Services, addresses market reform regulation, covering guaranteed issue, community rating and rate review.